NPIMap

Organization Active NPI

Imperial Health LLP

  • Family Medicine Physician
  • Deridder, LA
National Provider Identifier
1053929166
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
IMPERIAL HEALTH LLP
Practice address
200 W 5TH St
Deridder, LA 70634-4856
Phone
(337) 202-7850
NPI assigned
Jul 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nikki Lyn Dugas
Title
Credentialing Coordinator
Phone
(337) 312-8528

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

200 W 5TH St
Deridder, LA 70634-4856

Mailing address

501 Dr Michael Debakey Dr
Lake Charles, LA 70601-5724

Other identifiers 1

IdentifierTypeStateIssuer
1016314MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Urgent Care Clinic41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1053929166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 5TH ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344856",
            "telephone_number": "337-202-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL HEALTH LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-15",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "DUGAS",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "337-312-8528"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016314",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.